Orthotics are typically custom-fitted devices designed to provide support for muscles or other tissues that have been damaged or weakened in some manner, as for example by injury or disease. Cervical thoracic orthotics (CTOs) are particularly designed to provide support to the head, and cervical and thoracic spine. Because wearers can have profoundly different proportions, orthotics are generally made in multiples sizes. This can be time consuming and expensive to medical practitioners who have to stock and keep track of the different sizes.
Adjustable orthotics have been designed to address the problems associated with multiple-sized orthotics. For example, U.S. Pat. No. 5,964,722 to Goralnik, et al. teaches a cervical thoracic brace having a collar with parts coupled by detachable straps. Although the detachable straps allow the collar portion to be adjusted to the wearer, the brace fails to provide any relative movement between the cervical and thoracic portions. Goralnik and all other extrinsic materials discussed herein are incorporated by reference in their entirety. Where a definition or use of a term in an incorporated reference is inconsistent or contrary to the definition of that term provided herein, the definition of that term provided herein applies and the definition of that term in the reference does not apply.
In an attempt to provide a CTO that allows some relative movement of the cervical and thoracic portions, U.S. Pat. No. 6,921,376 to Tweardy et al. describes a cervical brace that wraps around the collar, and can be connected to a thoracic portion by means of a rear strut. The cervical brace is supported by a chin strut and an anterior plate assembly that can be slidably connected to the cervical brace. The Tweardy device allows for superior/inferior (up/down) movement of the cervical portion relative to the thoracic portion, but fails to allow for angular adjustment of the cervical and thoracic portions. That failure can prevent the device from properly fitting certain patients, including especially those having an extreme kyphosis of the upper thoracic spine, and/or obese patients.
U.S. Pat. No. 2,223,276 to Ward describes a CTO having cervical and thoracic pieces that are sagittally adjustable relative to one another by pivotally intermediate pieces (“irons”) relative to one another. One problem, however, is that the pivot points of Ward's intermediate pieces merely provide tightening, not splines or other locking mechanisms. Another problem is that Ward's tightening mechanism may require application of considerable torque to provide effective tightening, and even with such effort, a sudden application of force, such as by a fall or other wearer's movement, could readily alter the desired configuration.
Thus, there is still a need for CTOs that allows for sagittal adjustment between the cervical and thoracic portions, but that also has splines or other locking devices sufficient to prevent undesired or unintentional movements of the cervical and thoracic portions.